Another new variant of Bouveret's syndrome

Abstract

Although Bouveret's syndrome, i.e. gastric outlet obstruction by a large gallstone impacted in the proximal duodenum secondary to a cholecystoduodenal fistula, is rare, its pathogenesis and clinical features are well characterized. However, existence of variant forms of the syndrome are not well known, and as far as we know, only two cases of variant Bouveret's syndrome have been described in the English-language literature. We present a case of another new variant of Bouveret's syndrome in a 54-year-old Korean woman.

Figure 1

Gastroduodenal endoscopy revealed an ovoid mass in the first portion of the duodenum, the center of which harbored a mucosal defect.

Figure 2

Abdominal CT showed wall thickening at the bulbar and postbulbar portions of the duodenum, with marked gastric dilatation. A cystic lesion (arrow) was found at the thickened duodenal wall. The gallbladder was partially collapsed and adhered to the duodenum.